Endograft Collapse After Endovascular Aortic Aneurysm Repair With Acute Aortic Occlusion: A Case Report

TL;DR

A rare case of a collapsed endograft after aortic aneurysm repair caused leg pain and paralysis, but recovery was achieved through emergency surgery.

Contribution

This case report highlights a rare complication of EVAR and its successful management through thrombectomy and aortic cuff placement.

Findings

Proximal endograft collapse led to acute aortic occlusion and paraplegia.

Bilateral Fogarty thrombectomy and aortic cuff placement restored limb perfusion.

The patient regained motor function and was discharged after six days.

Abstract

We present the case of a rare complication of endovascular aortic aneurysm repair (EVAR), which is acute aortic occlusion due to proximal endograft collapse after EVAR. A 72-year-old man underwent EVAR and right internal iliac artery occlusion for aneurysms of the right common and right internal iliac arteries. One month after EVAR, the patient presented to the emergency room with an acute onset of bilateral lower-extremity pain and paraplegia. CT angiography revealed collapse of the proximal endograft and thrombosis of both iliac endografts. The patient underwent bilateral over-the-wire Fogarty thrombectomy and aortic cuff placement. Lower-extremity perfusion was restored upon completion of the procedure. The patient regained motor function and was discharged on postoperative day 6.

Figures